Provider Demographics
NPI:1912347394
Name:YUN, CHONG YON (MD)
Entity Type:Individual
Prefix:
First Name:CHONG
Middle Name:YON
Last Name:YUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JOY
Other - Middle Name:
Other - Last Name:YUN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1601 W HEBRON PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-6342
Mailing Address - Country:US
Mailing Address - Phone:972-426-8675
Mailing Address - Fax:972-492-4694
Practice Address - Street 1:1601 W HEBRON PKWY STE 100
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-6342
Practice Address - Country:US
Practice Address - Phone:972-426-8675
Practice Address - Fax:972-492-4694
Is Sole Proprietor?:No
Enumeration Date:2013-06-28
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXQ8398207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX363663101Medicaid
TX363663102Medicaid
TX363663103Medicaid